MEDICINE. 
141 
ever, it he suffered to run on into the stage 
pt' suppuration, the indications of this state 
are, the pulse becoming fuller and softer, the 
patient being attacked with shiverings, and a 
pulsatory feel in the affected part. Again, 
the tendency to gangrene is denoted by the 
tumour losing of its redness, and assuming a 
darkerdiue; by the sudden cessation of pain ; 
sometimes by blisters arising near or upon the 
tumour; and, lastly, if the local disorder have 
been considerable, by a rapid declension of 
[the pulse, and powers of life. . 
Treatment. The indications of cure are to 
be deduced from the sthenic or asthenic dis- 
position of the disease, and from the peculiar 
nature of the part or organ injured. 
Before the time of Dr. Brown, action, at 
least inflammatory action, was too indiscri- 
minately viewed as an evidence of power ; 
I the inference from this highly erroneous doc- 
trine was, that inflammation almost invaria- 
bly required for its cure a debilitating and 
f evacuating plan of treatment. Nothing can 
[be more inconsistent with the laws of the ani- 
Jmul economy. 
“ It had been,' 5 says the author of the Ele- 
Imenta Medic met*, “ a prevailing opinion that 
- the fits of the gout could not be constituted 
bv debility, because intlammat'on accompa- 
nies them. This question he subjected to 
the test of experiment, lie invited some 
friends to dinner; and by taking stimulants 
in their presence, recovered the most perfect 
use of that foot with which, before dinner, he 
could not touch the door for pain. By this he 
saw, that not only the gout itself, but the in- 
flammation accompanying it, was asthenic, 
that is, depending upon debility. Such he 
[found likewise to be the nature of the inflam- 
i mations in the gangrenous sore throat, in 
I chronic rheumatism, &c. &c.” The applica- 
tion of this principle in the practice of medi- 
I cine has proved of incalculable importance. 
[In conducting the cure, then, of inflammation*, 
Jthe physician is to he guided not so much by 
j the extent and degree of the local injury, as 
I by the nature of what Brown calls tiie pre- 
j vailing diathesis; if inflammation be attended 
I by a full, hard, and vigorous pulse, with other 
I expressions of power, a debilitating plan of 
treatment is to he adopted; blood is to he 
drawn from the arm, saline purgatives are to 
I he administered; cold, under the limitations 
I immediately to be mentioned, is to be ap- 
[plied, and the exciting powers as much as 
possible withdrawn. If, on the contrary, an 
I equal degree of local affection shall be ac- 
companied with feeble, although quick, 
j pulse, and the remaining symptoms of debi- 
I lity, an opposite plan, under certain regula- 
tions and exceptions, is to be pursued ; stimu- 
lants are to be thrown in, and the inflamma- 
tion cured by impelling and supporting the 
j torpid and feeble powers of the frame. But 
; from the peculiar nature of the part or organ 
j affected, the mode of treatment in the same 
degree and kind of inflammation will like - 
j wise be materially modified. Thus an asthe- 
I nic affection of the liver requires different sti- 
j muli from an asthenic affection of the stq- 
I mach. 
Again, although in inflammation, as in\ 
I fever, we generally recommend the cool treaty 
] ment, and consequent free admission of air,, 
jit is to he recollected that this principle is 
I objectionable in some kinds of inflammations, 
as of the lungs. For example, in small-pox 
and in measles, we shall have the same degree 
ot pyrexia, or fever, present ; and cold air 
would he equally indicated in either, were 
we to infer the proper method of treatment 
alone from the inflammatory excitement; 
hut in measles the lungs are often the prin- 
cipal seat of the local affection, an oxygenous 
or pure atmosphere would prove too stimu- 
lating to these organs ; and thus if we pur- 
sued general doctrines without particular ex- 
ceptions, or overlooked “ the peculiar na- 
ture of the part or organ injured,” the object 
of our plans would be frustrated and de- 
feated. 
As it relates to this important principle in 
medicinal agency, the system of Dr. Brown 
is exceedingly deficient. The peculiar sus- 
ceptibility of the separate organs our author 
overlooked in the rapid and general survey 
which he took of the animal economy. 
Genus I. Ophthalmia, inflammation of the 
eyes. See Surgery. 
Genus II. Phrenitis, inflammation of the 
brain. This,, as a sthenic affection, independ- 
antly of proper maniacal disorder, or febrile 
affection, is an extremely rare disease. 
Symptoms. Redness of the fact* and eyes, 
impatience of light and sound, watchfulness, 
and furious delirium. 
Mcthodus medendi. Copious evacuations. 
“ Foment the head with cold water for hours 
together.” Blisters. Blood to be drawn from 
the temporal artery. 
N. B. The delirium of fever, which has 
been supposed to indicate an inflammation of 
the brain, is for the most part of an asthenic 
nature, and requires stimuli. 
Genus I II. Cynanche, quinsy. 
Species ,1st. Cynanche tonsillaris, com- 
mon inflammatory sore throat. 
M. M. Acid gargles. Saline purgatives. 
Blisters. Antimonial diaphoretics. 
Species 2d. Cynanche maligna. An ac- 
cidental, but very common, symptom of scar- 
let fever. See Scarlatina. 
Species 3d. Cynanche trachealis, croup. 
See Infancy. 
Species 4th. Cynanche pharyngaea, a mere 
extension into the pharynx of the cynanche 
tonsillaris. 
Sp. 5th. Cynanche parotkkea. The mumps is 
an affection of the parotid and maxillary glands, 
which appears in the form of a swelling under 
the jaws: it is more common in some than in 
other counties of England. It sometimes 
appears as an epidemic. The mumps is in 
itself a slight disease ; hut after its declension, 
which is in general about the fourth day, the 
testes in men, and breasts in women, are very 
apt to he affected v flu swelling, in conse- 
quence ot some peculiar sympathy of these 
parts with the throat. 
M. M. If delirium supervene upon the 
retrocession of the swellings, blisters. “ Fo- 
ment the head with warm water.” Darwin. 
Genus IV. Pneumonia, inflammation of 
; the lungs. 
Genus V. Carditis, inflammation of the 
heart or pericardium. 
Genus \ I. Peritonitis, inflammation of 
the peritoneum. 
The disorder which is usually termed in- 
flammation of the lungs varies in some mea- 
sure its seat. Thus the diseased action shall 
he directed towards that part of the pleura 
which is called the pericardium, and then it 
may be called carditis ; or it may pass down 
the diaphragm, or the peritoneum, and form 
the peritonitis of Cullen, the diaphragm y.tis 
of Darwin. 
J he general symptoms are, pyrexia, pain 
in the chest, difficult) 1 of breathing, cough ; 
and, if the disorder happen in the sthenic 
diathesis, the pulse is hard and frequent. 
Sometimes the expectoration is tinged with 
blood. 
r I he particular symptoms are, in carditis, 
palpitation, with unequal intermitting pulse, 
pa ; n in the region of the heart, vomiting, 
fainting: it the inflammation he particularly 
directed to the diaphragm, the pain is situated 
towards the lower ribs, the respiration in a 
recumbent posture is extremely difficult, and 
the corners of the mouth are sometimes so 
retracted as to form a disagreeable smile, 
called risus sardonicus. 
M. M. If is of the utmost importance to* 
attend to the prevailing diathesis. If the 
constitution is sthenic, and the disorder ur- 
gent, immediate and copious bleeding. Re- 
frigerant and emollient cathartics. Cool and 
equal, not: cold and irregular, atmosphere. 
Diluent drinks. Total abstinence from ani- 
mal food, sometimes during the first live days. 
Antimonial preparations. After venesection 
a blister on the pained part. Digitalis. In 
Dr. Currie’s Medical Reports we find the fol- 
lowing observations : “ 1 have employed the 
digitalis to a very considerable extent in ii> 
{laminations of the brain, of the heart, and 
the lungs ; and have succeeded with it in 
cases where I otherwise should have despair- 
ed.” In Dr. Reid’s Treatise on Consump- 
tion we meet with an acquiescence in this 
sentiment on the fox-glove. Our experience, 
however, has taught us to value this remedy 
principally in other pulmonary affections than 
the more violent kinds of inflammation, as is 
mentioned under the head of phthisis. After 
the excitement has been moderated, opium 
in small doses. “ Do neutral salts increase 
the tendency to cough?” .Pediluvium. Small 
doses of calomel, to prevent adhesions. 
N. B. [f pneumonia run on into suppura- 
tion pus will he discharged by .cough, and 
thus a species of consumption he formed ; or 
wid he detained in the cavity of the chest, 
and constitute empyema. In either case, di- 
gitalis in large doses.. Calomel. Opium.-. 
Peruvian bark. 
Genus VII. Gastritis, inflammation of the 
stomach. 
Symptoms. Violent pain in the region of 
the stomach, with pyrexia; small, frequent, 
and sometimes contracted, pulse ; vomiting;- 
hiccough. ° 
Cituses. If may be occasioned by any thing 
acrid taken into the stomach ; by blows on 
the region of this organ ; and a slight species 
of it is often consequent upon taking cold - li- 
quids after exercise. 
M.M. In inflammation of the stomach 
and bowels we have, in some measure, an 
exception to the general rule of cure, accord- 
ing as the disease appears sthenic or a_*henic.. 
'Ihe pulse and vital powers are often sud- 
denly reduced, and yet venesection is re- 
quired. Warm bath. Fomentations.. An©-- 
